1. Field of the Invention
This invention relates to devices and procedures for their use in an arthroscopic surgical procedure for replacement of a knee cruciate ligament.
2. Prior Art
The present invention is in a device and its use for conveniently threading and mounting a tendon, or the like, into a closed femoral section of a straight ligament tunnel, that has been formed through the tibia and ligament points of origin and into the femur endosteum, for replacing a knee anterior cruciate ligament. Recently, in the field of arthroscopic surgery, for replacement of a knee anterior cruciate ligament, a procedure has been developed that, with the knee bent appropriately, involves forming a straight tunnel through the tibial tuberosity, across the anterior cruciate points of origin on the proximal tibia and distal femur surfaces, and into the femur endosteum. An end of a replacement ligament, either natural or prosthetic, is then fitted through the tibial opening and along the tunnel for seating in the femur endosteum. Some examples of which straight tunnel formation procedures and connectors for endosteally mounting a ligament end in the tunnel femur end section are shown in patents to Goble, et al, U.S. Pat. Nos. 4,772,286, 5,129,902, and 5,147,362. None of which procedures or devices, however, involves fitting a straight tube mounting a tendon into the closed femur section of a straight ligament tunnel and a procedure for mounting that tendon therein, like that of the invention.
The tendon threader of the invention is used to position a tendon in a femur tunnel section of a straight ligament tunnel. Once so positioned the tendon can be maintained therein by fitting a pin through the femoral tunnel and through the tendon threader with a tendon fitted thereover, forming a loop. The pin, as visualized arthroscopically looking through the tendon threader tubular body or on a fluoroscopic monitor, is fitted through the tendon loop, capturing it as a permanent tendon mounting. The tendon can then be drawn over the pin to where the ends are aligned. The aligned tendon ends can then be mounted, as by stapling them onto the bone surface, adjacent to the open tibial tunnel end. Heretofore, maintaining a ligament, tendon, or the like, in a closed ligament tunnel end, has required a connector device like those described in the above set out patents. Or an interference type device was fitted into the tunnel section, urging the tendon against the tunnel surface, locking it in place. An example of such an interference device is shown in a patent to Parr, et al, U.S. Pat. No. 4,744,793; with interference screws shown in patents to Goble, et al, U.S. Pat. No. 4,927,421; and to Bowman, et al, U.S. Pat. No. 4,950,270. None of which interference devices, however, involves use of a transverse pin like that of the invention whereover a tendon or ligament is looped over the pin set across the tunnel for both tendon positioning and as an endosteal mounting.
Within the knowledge of the inventors, in a practice of an arthroscopic surgical procedure on a patient's knee, no device has heretofore addressed the need for conveniently fitting a tendon, or the like, into a closed femoral tunnel section of a straight ligament tunnel and securing it by fitting a transverse pin therein like the tendon threader and process for its use of the invention.